Returning Blood Sugar to Normal Went With Less Heart Death and Heart Failure

CATEGORY: METABOLIC & BLOOD SUGAR

If you have prediabetes—blood sugar that is higher than normal but not yet in the diabetes range—bringing it back down to normal does far more than lower your odds of developing diabetes. A major new analysis of two landmark prevention trials found that people who returned their blood sugar to normal cut their risk of dying from heart disease or being hospitalized for heart failure by roughly half, and that protection lasted for decades.¹

Normal Blood Sugar, Confirmed With Standard Tests

Prediabetes remission simply means getting your blood sugar back into the normal range and keeping it there. Doctors confirm it with standard blood tests, the same ones used to diagnose prediabetes in the first place. The encouraging part is that this is an achievable goal for many people, usually reached through steady weight loss, more physical activity, and improvements in diet—the same habits that support overall health.

60% Lower Risk Over 20 Years in U.S. Trial

For years, the goal for people with prediabetes has been to slow the slide toward full diabetes. This research shows the risk can actually be turned in the other direction, with lasting rewards for the heart. In the U.S. trial, people who reached remission had roughly 60 percent lower risk of cardiovascular death or heart-failure hospitalization over 20 years of follow-up, and a parallel Chinese trial confirmed a similar benefit over 30 years. In the US trial, cardiovascular death or hospitalization for heart failure occurred at 1.74 per 1,000 person-years among those reaching remission, versus 4.17 among those without.¹ When the two were combined, reaching remission at any point cut that risk by more than half.¹

Vessel Damage, Strain, and a Lasting Legacy Effect

Chronically elevated blood sugar quietly damages blood vessels and strains the heart over time. By returning glucose to a normal range, you reduce that ongoing injury, which helps explain why the benefit persisted long after the original programs ended. In other words, the gains you make now can keep paying off many years down the road—what researchers describe as a lasting “legacy” effect.

Two Hour Glucose Test Versus Fasting and HbA1c

A long-running study of British civil servants points partly the same way. People whose prediabetes was flagged by a two-hour glucose test—blood sugar measured after a sugary drink—and who returned to normal had roughly half the rate of cardiovascular events and death; those flagged by fasting blood sugar or HbA1c, a marker of average blood sugar, showed no such difference.² How far the benefit travels may depend on which test identified the prediabetes.

Key Takeaways

• In people with prediabetes, returning blood sugar to normal was linked to lasting heart protection—not just a lower chance of developing diabetes.
• In the trials, remission was reached mainly through steady weight loss, more physical activity, and dietary improvement; even modest, sustained changes were enough for many.
• The protection lasted: roughly 60% lower risk of cardiovascular death or heart-failure hospitalization over 20 years in the U.S. trial, with a similar benefit over 30 years in a parallel Chinese trial.

References

1. Vazquez Arreola E, Gong Q, Hanson RL, et al. Prediabetes remission and cardiovascular morbidity and mortality: post-hoc analyses from the Diabetes Prevention Program Outcome study and the DaQing Diabetes Prevention Outcome study. Lancet Diabetes Endocrinol. 2026 Feb;14(2):137-148. link
2. Vistisen D, Kivimäki M, Perreault L, et al. Reversion from prediabetes to normoglycaemia and risk of cardiovascular disease and mortality: the Whitehall II cohort study. Diabetologia. 2019;62(8):1385–1390. link.